Singapore Hand and Wrist Specialist Centre
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Hand and Wrist pain can be caused by one or more of a number of different disorders. Lifestyle diseases will become more common as we live longer and lead more active lives. Hand and wrist pain are among these lifestyle diseases. They are usually amenable to simple treatment strategies, provided they are diagnosed early.
Why are the hand and wrist special?
The hand and wrist are our main point of physical contact with the world. They manipulate objects to aid us in our daily lives. As such, pain that disables our hand and wrist can lead to a marked decrease in our ability to functional at work and play.
Which parts of our hand and wrist are commonly affected by pain?
– Hand pain
A common cause of hand pain that many feel at the base of their fingers, in the palm of the hand, is trigger finger. Trigger finger is a condition where a patient feels pain or discomfort when trying to straighten or bend their finger/thumb. Sometimes the finger may become ‘locked’ or ‘stuck’ when swelling of the tendon sheath occurs. This swelling can be associated with diabetes, rheumatoid arthritis, or even golf.
Carpal Tunnel Syndrome can also cause hand pain. There is a tunnel in the wrist called the carpal tunnel. Nine tendons and the median nerve pass through it. When pressure builds up in the tunnel, the nerve gets compressed and is unable to function properly. This may result in numbness, discomfort and pain in the fingers. This condition usually associated with a tingling sensation over the thumb, index and middle fingers, especially at night. Risk factors for carpal tunnel syndrome include age, diabetes and rheumatoid arthritis.
Another common cause of finger pain is trauma. In this instance, the injured tissue could be the tendon, ligament, bone, or even a combination. It is thus imperative that all injured tissues are adequeately addressed and optimally treated.
– Wrist Pain
Wrist pain is more complex. It is usually divided into conditions that cause pain on the radial side of the wrist, i.e. nearer the thumb, and those that cause pain on the ulnar side of the wrist, i.e nearer the little finger.
Radial-sided wrist pain
Radial-sided wrist pain can be caused by an injury to an important ligament called the scapholunate ligament. This ligament helps two important bones of the wrist joint, namely the scaphoid and the lunate, move in unison. When this ligament is injured, these bones no longer move in tandem, thus leading to pain. This would be aggravated by motion and lead to accelerated arthritis in the wrist, which in turn, manifests as stiffness and poor grip strength.
In addition, woman who are in the perinatal period also belong to a unique population who can suffer from a tendon condition called Dequervain’s Tenosynovitis. It is a condition in which one feels pain over the wrist joint near the base of the thumb. It begins as an aching sensation initially, and progresses to a point when any movement of the wrist or thumb produces sharp pain in the affected area. That area of the wrist may become swollen at times. Often, nursing mothers affected for the period that they are caring for their newborns. This is due to poor ergonomics, or by the hormonal changes that affect their tissues.
Ulnar sided wrist pain
Ulnar sided wrist pain is common in a patient who has sustained a twisting injury or a fall on an outstretched hand. This is usually due to a tear of a ligamentous structure called the “triangular fibrocartiligeneous complex”, which stabilises the wrist joint. Patients with this problem can experience pain in their wrists associated with instability and diminished grip strength. Like the radial side of the wrist, tendons on the side of the wrist can also suffer from inflammation which causes pain, and is usually caused by overuse.
How do we diagnose such conditions?
Firstly, we take a history from our patients. This includes finding out the circumtance surrounding their complaint, as well as the nature of the complaint. This can help us ascertain the tissue that is the main “pain generator”.
Secondly, a thorough clinical examination of the hand and wrist helps us confirm or rule out the possible reaons for our patient’s pain.
X-ray, fluoroscopy (real time X-rays), computed tomograpgy (CT) scans and magnetic resonance imaging (MRI) scans are all important diagnostic tools to help Hand Surgeons confirm diagnoses.
Arthroscopy of the wrist is currently the gold standard diagnostic procedure of choice when the internal architecture of the joint, such as the cartilage, needs to be assessed. Therapeutic key-hole surgery can also be performed with the aid of this tool.
Most common causes of Hand and Wrist problems includes:
CARPAL TUNNEL SYNDROME – Carpal tunnel syndrome occurs when the median nerve which runs from the forearm into the hand becomes pressed or squeezed at the wrist.
DE QUERVAIN’S STENOSING TENOSYNOVITIS – is a condition brought by irritation or inflammation of the wrist tendons at the base of the thumb.
MALLET FINGER – Mallet finger occurs when the outermost joint of the finger is injured. With mallet finger, the tendon on the back of the finger is separated from the muscles it connects.
TRIGGER FINGER – Trigger finger is a common disorder of the hand which causes painful snapping or locking of the fingers or thumb.
ARTHRITIS – Osteoarthritis of the fingers and thumb is characterized as chronic and often disabling pain and stiffness of one or more joints
HEBERDEN’S NODES – are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).
WRIST GANGLION CYST – is a swelling that usually occurs over the back of the hand or wrist. These are benign, fluid-filled capsules.
Read more about Wrist Ligament Injuries
Read more about Common Causes Numbness in Hands
Read more about Flexor Tendon Injuries
Get your Hand/Wrist pain cure today! Call (65) 6471 2744 – 24 Hours or SMS to (65) 92357641 to schedule for an appointment